LET'S TALK AGING: Honoring dementia resistance and refusals

Wednesday

Aug 2, 2017 at 12:01 AMAug 3, 2017 at 10:23 AM

Barbara Harrison

Caring for a person living with dementia is challenging. As a caregiver, your greatest wish is to protect and enhance the life of your loved one. Unfortunately, the all-consuming nature of caregiving can make it easy to miss subtle triggers that may cause your loved one to resist your best intentions.

The key to identifying and avoiding these triggers is to look closely at the activity or situation that causes resistance or refusal.

What, when, where, how

Is the activity or situation that caused an upset a change from your loved one’s established routine? Making a shift in how or when you do something may seem insignificant to you, but it could very well trigger anxiety and confusion for a person with memory impairment.

People living with dementia thrive on familiarity and consistency. Because dementia gradually impairs one’s ability to plan and execute activities, establishing a daily routine provides a sense of comfort and calm. It’s likely that you’ve already established a routine for your loved one—the key is to stick to it whenever possible.

It’s also important to look for patterns in the resistant behavior. Does it frequently occur during a particular time of day? Are there certain activities, environments or settings that seem to create agitation? These are all things to take note of.

Additionally, pay attention to the way you interact with your loved one when an upset happens. Tone of voice, choice of words, physical action/body language and your reactions can play a role in both triggering and calming your loved one.

Sensory input

People with dementia experience a decline in the way their primary senses function. How your loved one processes and understands what he or she sees, hears, smells, tastes and touches will change over time. The shift can mean losing taste for a food they once loved, or becoming sensitive to sounds that didn’t bother them in the past, such as background noise from a TV or radio.

Take into account the environment surrounding your loved one when resistance occurs. Is there a lot of extra noise in the room? This can be overwhelming and distracting. How is the temperature? Ask them if they are too hot or cold, or if their clothes are uncomfortable.

Consider also the kind of physical sensations they might be experiencing during an activity that seems to trigger opposition. Pain during movement will take its toll on anyone. Does the activity require a different position or body involvement, and is there a way of altering it?

Easing stress

Once you’ve identified characteristics and surrounding influences, experiment with ways of increasing activities and situations that promote peace and happiness while reducing those that seem to agitate or cause confusion. Figure out which actions or activities de-escalate stressful situations and keep those in your back pocket.

Being patient and supportive toward your loved one can also go a long way. Try speaking more softly and slowly when resistance seems to be climbing. Provide gentle reminders of date and time when it appears your loved one might need them. If pain seems to be an influence in your loved one’s agitation or resistance, talk to their health provider about possible solutions.

Always remember that you are a vital part of the picture, too. When you’re stressed and tired, this reduces your ability to remain patient, calm and supportive. This in turn can cause stress in your loved one and contribute to problem behavior. Make sure you are taking care of yourself—caregiving is challenging and taxing, and getting the support you need will help you provide the best possible care, increasing quality of life for you and your loved one alike.

Barbara Harrison is executive director at Bridges by EPOCH at Pembroke, a memory care assisted living community that will open in fall 2017. She can be reached at bharrison@bridgesbyepoch.com.